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All respondents must be aged 18+ and comfortable participating in English-language discussions in order to participate. The specific inclusion criteria for each audience are outlined below.

Participants in high incidence states must live in one of the following states:

Connecticut, Delaware, D.C., Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, Wisconsin

Participants in emerging incidence states must live in one of the following states:

Illinois, Indiana, Iowa, Michigan, North Carolina, Ohio

Participants in high-intensity outdoor enthusiast groups must:

Have participated in any in any of the following activities 6+ times from May to October 2024, and plan to do so with similar frequency in May to October 2025: hiking, camping, trail running, mountain biking, etc.

Participants in low-intensity outdoor enthusiast groups must:

Have participated in any in any of the following activities 6+ times from May to October 2024, and plan to do so with similar frequency in May to October 2025: gardening, park visits and walks, picnicking, bird watching, etc.

Participants in parent groups must:

Be a primary caregiver to a child between the ages of 5 to 15.
Have their child be regularly active outdoors in warmer months (May to October).

Potential participants are drawn from a national panel of individuals who have opted in to participate in focus groups or interviews on various topics. The contractor KRC Research will direct a subcontracted panel provider to distribute an invitation to screen for the focus groups to members of its panel, starting with those individuals whose panel profiles suggest they are most likely to qualify (e.g., those who are parents and live in high or emerging incidence states). When an individual receives the invitation to screen, they will either complete a screening questionnaire online (Attachment 1) or via the phone in a call with a panel provider staff member. Individuals must pass the screening questionnaire without being disqualified based on their answers or due to quotas reached on certain characteristics.

A total of 48 participants will be purposively selected for this project (24 individuals from high incidence states and 24 individuals from emerging incidence states). Within the parameters of each subpopulation, participants will be selected to maximize variability across age, sex, geographic region, and type of region (urban, suburban, small town/rural) to ensure a diversity of experiences.

Selected participants will be invited to confirm their interest and availability in participating. Once confirmed, a confirmation message will be sent to the participants with logistical information, as well as the date and time of the focus group. A day or two prior to the scheduled discussion, participants will receive a reminder email. To incentivize participation, participants will be offered a $75 incentive for their time, in line with market research recruitment standards for this audience. If, at the time of invitation, the participant declines to participate, a replacement participant will be selected from the pool of eligible participants.

A contracting company will conduct all recruitment and screening activities.

Procedures for the Collection of Information

After completing screening, eight focus groups will be conducted that will last no more than 90 minutes. Prior to the discussions, participants will be required to sign and date a consent form that outlines the details about the focus group, such as confidentiality and incentive (Attachment 2). They will be sent the form electronically and required to sign it electronically. Project records will be maintained in accordance with the federal record retention requirements. Additionally, at the start of each discussion, respondents are given a brief verbal reminder of the consent form details.

Trained moderators from the contracted firm KRC Research will conduct all focus groups as well as oversee recruitment and screening (described in Section 1). The moderator will use a semi-structured guide for all focus groups (Attachment 3). The questions in the guide explore participants' knowledge, attitudes, beliefs, and behaviors related to Lyme disease and its prevention, as well as reactions to the creative concepts and messages being tested.

With the consent of each participant, discussions will be audio and video recorded to capture the content of the focus group. Recordings will be transcribed into transcripts which will be used for analytic purposes in the development of a report. Field notes will be taken during the discussions to capture key quotes or expressions. No recordings or transcripts with personally identifiable information will be shared outside of the KRC Research team conducting and analyzing the focus groups.

Methods to Maximize Response Rates and Deal with No Response

By design, all potential participants in these focus groups will be drawn from a panel of individuals who have opted in to participate in studies like this one. The use of panel sampling helps to maximize the efficiency of recruiting, since all possible participants are familiar with the recruiting contractor, and many will have been contacted before. Additionally, to maximize response, the screening questionnaire (Attachment 1) is intentionally designed to collect only the minimum amount of information needed to determine the qualifications of participants, and quotas for several demographic variables are “loose,” meaning that there is no exact number of individuals who must be recruited with certain criteria. (For example, recruiting “a mix” of individuals with different incomes and education levels, instead of a specific number.) This reduces the number of individuals who will be screened.

It is sometimes the case that participants do not sign in on time for their focus group, either for unexpected personal reasons, forgetfulness, or other reasons. To minimize the instances of this occurring, respondents are given several days’ advance notice of the focus group and are sent reminder emails the day before and day of the scheduled discussion. Should they still not appear, the moderating team at KRC Research has protocols in place so that the recruiting team can quickly email or call the participant to confirm availability, or to reschedule as needed. If the respondent is entirely unresponsive, they may be replaced after the day of the planned discussion.

At the beginning of each discussion, participants will be reminded that their participation is voluntary, they do not need to answer any question that they are not comfortable answering, and they may leave the focus group at any time if desired.

Test of Procedures or Methods to be Undertaken

No pre-tests are planned for this project.

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Author	CDC User
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File Created	2025-07-02